Bacteremia Caused by Rare NFGNB in the ICU: A Single-center Experience.

Abstract

Introduction: Amongst the non-fermenting gram-negative bacteria (NFGNB), Pseudomonas (P.) and Acinetobacter species predominate the landscape. However, less common NFGNB such as Burkholderia, Stenotrophomonas, Achromobacter, Ralstonia and Elizabethkingia species, amongst others, are assuming increasing importance. We describe a single-center experience of bacteremia caused by rare NFGNBs in an Indian intensive care unit (ICU).

Materials and methods: A retrospective study of adult patients with bacteremia caused by rare NFGNB in the ICU.

Results: Of the total 205 cases, Burkholderia (B.) species (43.4%, n = 89) were the commonest, followed by Stenotrophomonas species (20.4%, n = 42). The bacteremia was related to an indwelling catheter in 42.9 % of the patients. The median duration of hospitalization preceding the bacteremia was 16 days. Except for B. Achromobacter and Aeromonas species, meropenem showed high rates of resistance. Overall, cotrimoxazole, levofloxacin and minocycline were the most effective antibiotics active in vitro; with some differences noted specific to different organisms. The overall day 28 mortality was 34.1%. On multivariate analysis, the presence of shock (p = 0.008, CI: 1.188-5.052) and receipt of steroids (p = 0.015, CI: 1.032-3.891) were significantly associated with mortality.

Conclusions: This is one of the largest studies from India, describing the landscape of NFGNB causing bacteremia in the ICU. Our study shows that these infections are acquired late during the course of hospitalization, have limited therapeutic options, and can be associated with significant mortality. Implementation of stringent infection control practices is needed to reduce this threat.

How to cite this article: Prayag PS, Rajhans P, Mahale N, Patwardhan SA, Dhekane PN, Soman RN, et al. Bacteremia Caused by Rare NFGNB in the ICU: A Single-center Experience. Indian J Crit Care Med 2025;29(4):345-351.